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New York rates for HCPCS 58573

Laparoscopy, surgical, with total hysterectomy, for uterus greater than 250 g; with removal of tube(s) and/or ovary(s)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,658.13 / $6,962.00 / $17,284.46
Aetna
Facility/Professional
Facility
Modifier
22
Low / Median / High Price
$8,692.56 / $8,692.56 / $23,311.72
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,989.00 / $10,294.00 / $23,873.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,720.85 / $3,183.00 / $13,009.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,393.58 / $12,209.00 / $34,562.00
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$136.90 / $136.90 / $136.90
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $2,119.52 / $4,093.18
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,454.70 / $13,521.66 / $26,415.28
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$597.00 / $1,393.58 / $34,562.00
MVP Health Care
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$136.90 / $136.90 / $136.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,444.00 / $6,762.00 / $16,243.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,395.57 / $1,395.57 / $4,116.85